Mechanical Low Back Pain: This is the most common cause of back pain near the hips, often resulting from strain or overuse of the muscles and ligaments in the lower back. It can be exacerbated by poor posture, heavy lifting, or sudden movements.

Degenerative Disc Disease: Wear and tear on the spinal discs can cause pain in the lower back, radiating to the hips. This condition is common in older adults and can be exacerbated by activities that put strain on the spine.
Herniated Disc: A herniated disc in the lumbar spine can cause pain, numbness, and tingling in the lower back and hips. This occurs when the soft inner gel of the disc leaks out through a tear in the outer layer.
Osteoarthritis of the Hip: Arthritis in the hip joint can cause pain that radiates to the lower back. This condition is characterized by the breakdown of cartilage in the joint, leading to bone-on-bone contact and pain.
Sacroiliitis: Inflammation of the sacroiliac joints, which connect the sacrum to the ilium bones, can cause pain in the lower back and hips. This condition can be caused by various factors, including arthritis, infection, or injury.

Cauda Equina Syndrome: A serious condition that occurs when the nerves in the spinal canal are compressed, causing pain, numbness, and weakness in the lower back and legs. If left untreated, it can lead to permanent nerve damage.
Spinal Infection (Osteomyelitis or Discitis): Infections of the spine can cause severe back pain, fever, and other systemic symptoms. Prompt diagnosis and treatment are crucial to prevent serious complications.
Fracture: A fracture in the vertebrae or hip can cause severe back pain, especially if it occurs spontaneously or with minimal trauma, as seen in osteoporotic fractures.
Tumor: Although rare, tumors in the spine or hip can cause back pain. It's essential to consider this possibility, especially if the pain is persistent, worsening, or accompanied by other systemic symptoms like weight loss or fatigue.

Ankylosing Spondylitis: A chronic inflammatory disease that can cause the vertebrae to fuse together, leading to stiffness and pain in the lower back and hips.
Spondylolisthesis: A condition where a vertebra slips out of place, potentially causing pain and nerve compression in the lower back and hips.
Paget's Disease of Bone: A condition characterized by abnormal bone remodeling, which can cause pain, deformity, and other complications in the affected bones, including those in the spine and hip.